Abstract
The plasma thyrotropin (TSH) and prolactin (PRL) responses to thyrotropin releasing hormone (TRH) were studied before and during lithium treatment for 3–4 weeks in 6 patients with manic states and 8 control subjects. The plasma TSH responses to TRH were not different between the two groups before lithium treatment. Lithium administration did not alter non-stimulated secretion of TSH in any groups, but resulted in exaggerated responses of plasma TSH to TRH in both groups. No difference between two groups was observed in plasma TSH responses to TRH.
The basal plasma PRL concentration did not differ between the two groups and was not affected by lithium administration to either group. The plasma PRL responses to TRH in female subjects were greater than those in male subjects. In females, the plasma PRL responses to TRH in manic patients were significantly higher than those in control subjects before the treatment. Lithium administration caused enhanced responses to TRH in patients when compared to pretreatment levels, but not in control subjects. Although the small number of male subjects limits conclusions, pretreatment plasma PRL responses to TRH in male manic patients were apparently greater than those in control subjects. However, lithium administration appeared not to affect the responses of plasma PRL to TRH in manic patients when compared to pretreatment levels.
The augmented responses of plasma PRL to TRH in patients with manic states suggest the existence of some abnormality in the hypothalamo-pituitary axis. Thus, the effect of the anti-manic agent on PRL secretion in manic patients may suggest the machanism by which the drug affects manic symptoms.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ahlenius S, Engel J (1974) Potentiation by lithium of the haloperidol-induced behavioural suppression. J Neural Transm 35:83–86
Baer L, Kassir S, Pieve R (1970) Lithium induced changes in electrolyte balance and tissue electrolyte concentration. Psychopharmacologia 17:216–224
Buckman MT, Peake GT (1973) Osmolar control of prolactin secretion in man. Science 181:755–757
Bunney WE Jr, Davis JM (1965) Norepinephrine in depressive reactions. Arch Gen Psychiatry 13:483–494
Bunney WE Jr, Goodwin FK, Murphy DL (1972) The switch process in manic-depressive illness. III. Theoretical implications. Arch Gen Psychiatry 27:312–317
Burrow GN, May PB, Spaulding SW, Donabedian RK (1977) TRH and dopamine interactions affecting pituitary hormone secretion. J Clin Endocrinol Metab 45:65–72
Emerson CH, Dyson WL, Utiger RD (1973) Serum thyrotropin and thyroxin concentrations in patients receiving lithium carbonate. J Clin Endocrinol Metab 36:338–346
Forrest JNP, Cohen AD, Torretti J, Himmelhoch TM, Epstein FH (1974) On the mechanism of lithium-induced diabetes insipidus in man and the rat. J Clin Invest 53:1115–1123
Gerner RH, Post RM, Bunney WE Jr (1976) A dopaminergic mechanism in mania. Am J Psychiatry 133:1177–1180
Kirkegaard C, Bjørum N, Cohen D, Lauridsen UB (1978) Thyrotropin releasing hormone (TRH) stimulation test in manic-depressive illness. Arch Gen Psychiatry 35:1017–1021
Lal S, Nair NPV, Guyda H (1978) Effect of lithium on hypothalamic-pituitary dopaminergic function. Acta Psychiatr Scand 57:91–96
Lauridsen UB, Kirkegaard C, Nerup J (1974) Lithium and pituitary-thyroid axis in normal subjects. J Clin Endocrinol Metab 39:383–385
Lazarus JH, Bennie EH (1972) Effect of lithium on thyroid function in man. Acta Endocrinol 70:266–272
Lindstedt G, Nilsson L, Wålinder J, Skott A, Öhman R (1977) On the prevalence, diagnosis and management of lithium-induced hypothyroidism in psychiatric patients. Br J Psychiatry 130:452–458
MacLeod RM, Lehmeyer JE (1974) Studies on the mechanism of the dopamine-mediated inhibition of prolactin secretion. Endocrinology 94:1077–1085
McLarty DG, O'Boyle JH, Spencer CA, Ratcliffe JG (1975) Effect of lithium on hypothalamic-pituitary-thyroid function in patients with affective disorders. Br Med J 3:623–626
Meites J, Clemens JA (1972) Hypothalamic control of prolactin secretion. Vitam and Horm 30:165–221
Murphy DL, Goodwin FK, Brodie KH, Bunney WE Jr (1973) l-dopa, dopamine, and hypomania. Am J Psychiatry 130:79–82
Nielsen JL, Amdisen A, Darling S, Pedersen EB (1977) Plasma prolactin during lithium treatment. Neuropsychobiology 3:30–34
Prien RF, Caffey EM, Klett CJ (1972) Relationship between serum lithium level and clinical response in acute mania treated with lithium. Br J Psychiatry 120:409–414
Schildkraut JJ (1965) The catecholamine hypothesis of affective disorders: a review of supporting evidence. Am J Psychiatry 122:509–522
Schou M, Amdisen A, Jensen SE, Olsen T (1968) Occurrence of goitre during lithium treatment. Br Med J 3:710–713
Snyder P, Jacobs LS, Utiger RD, Daughaday WH (1973) Thyroid hormone inhibition of the prolactin response to thyrotropin releasing hormone. J Clin Invest 52:2324–2329
Stokes PE, Kocsis JM, Arcuni OJ (1976) Relationship of lithium chloride dose to treatment response in acute mania. Arch Gen Psychiatry 33:1080–1084
Takahashi S, Kondo H, Yoshimura M, Ochi Y (1975) Thyroid function levels and thyrotropin responses to TRH administration in manic patients receiving lithium corbonate. Folia Psychiatr Neurol Jpn 29:231–237
Takahashi R, Nakane Y, Akiyama A (1979) Lithium treatment in affective disorders from viewpoint of transcultural psychopharmacology: therapeutic plasma level. Folia Psychiatr Neurol Jpn 33:501–509
Villeneuve A, Gautier J, Jus A, Perron D (1974) The effect of lithium on thyroid in man. Int J Clin Pharmacol 9:75–80
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Tanimoto, K., Maeda, K., Yamaguchi, N. et al. Effect of lithium on prolactin responses to thyrotropin releasing hormone in patients with manic state. Psychopharmacology 72, 129–133 (1981). https://doi.org/10.1007/BF00431645
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00431645